Individual
BRENT R DEGEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 JEFFERSON PARK AVE FOURTH FL, CHARLOTTESVILLE, VA 22908-0136
(404) 924-5078
(434) 924-8118
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
0101262506
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2010
Last updated
06/21/2019
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